Universal Sompo is one of the general insurance service providers operating in the country. The company offers insurance service in various domains including health, motor, commerce, etc. Health insurance is one of the major segments of the company, and it continues to compete with various top players in the industry. Universal Sompo Individual Health Insurance is a comprehensive health insurance plan offered by the company. This is an affordable health insurance cover designed for the middle-class population of the country.
The following eligibility criteria applies to those who wish to enroll themselves in the Universal Sompo Individual Health Insurance policy:
Some of the notable features of Universal Sompo Individual Health Insurance policy can be listed as follows:
The range of benefits offered by Universal Sompo Individual Health Insurance policy can be listed as follows:
|Benefits||Extent of Coverage|
|In-patient hospitalisation expenses (includes expenses for room rent, medicines, diagnosis, specialist fees, etc.)||Up to the sum insured limit|
|Day care treatment||Covered for all the procedures listed in the policy document|
|Domiciliary treatment||Available for medical treatment taken at home under certain conditions (must be at least 3 days or more)|
|Daily cash benefit||Up to 0.1% of the sum insured subject to a maximum of Rs.250 per day (cannot exceed Rs.2,500 in a policy period)|
|Emergency ambulance cover||Up to 1% of the sum insured amount subject to a maximum of Rs.1,000 per policy period|
|Cost of organ donor treatment||Covered|
|Health check-up||Up to 1% of the sum insured amount for every four claim-free years|
|Critical illness coverage (optional)||Covered for 5 conditions including cancer, paralytic stroke, chronic renal failure, coronary artery bypass, and major organ transplant|
The following list of conditions will not be covered by Universal Sompo Individual Health Insurance policy:
Universal Sompo offers both cashless treatment as well as reimbursement claim facility. The company has network tie-ups with over 4,000 hospitals located in different places across the country. You can contact the company’s customer service and intimate them about the claim. Intimation must be provided at least 48 hours ahead of planned hospitalisation and 24 hours within emergency hospitalisation. You can fill out the authorisation form in the network hospital and send it to the insurer. The company will verify the policy details and approve the authorisation request.
Reimbursement claims can be filed after discharge from the hospital. Along with the claim form, you must also provide various documents like policy copy, discharge summary, diagnostic reports, cash memos, medical bills, diagnostic reports, physician certificate, etc. Once the documents are submitted, the company will verify the document before approving the request. Following the approval, the company will reimburse the claim amount to the insured person.
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